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Children’s (Paediatric) Abdominal Ultrasound

Author: Dr Timothy Cain*

What are the prerequisites for having a paediatric abdominal ultrasound done?

Ultrasound examinations are particularly useful in the investigation of abdominal pain and abdominal masses in children. Although additional imaging may be required, the ultrasound examination will usually identify whether a mass is real or clinically significant or not. Ultrasound is now the modality of choice in the investigation of intussusception and can be useful in the investigation of appendicitis.

Radiologists require a clearly written request with sufficient clinical information to ensure that the most appropriate examination is performed. Not only does this enable the correct study to be performed, it also enables provision of a meaningful report.

What are the absolute contraindications for a paediatric abdominal ultrasound?

There are no absolute contraindications for a paediatric abdominal ultrasound.

What are the relative contraindications for a paediatric abdominal ultrasound?

If there are dressings or skin conditions that prevent adequate transducer contact or gel being applied to the abdomen, the study may not be successful.

What are the adverse effects of a paediatric abdominal ultrasound?

There are no adverse effects of a paediatric abdominal ultrasound.

Are there alternative imaging tests, interventions or surgical procedures to a paediatric abdominal ultrasound?

Investigation of acute abdominal trauma or retroperitoneal conditions is often better achieved with computed tomography (CT). Abdominal ultrasound studies may be inconclusive in some conditions. This is particularly true for appendicitis when failure to visualise the appendix is relatively common. When this happens, appendicitis, and even an appendiceal abscess may be present.

Abdominal pain in children can be the presentation for many conditions inside and outside the abdomen so other conditions should be considered. The most common sources of abdominal pain arising outside the abdomen include pneumonia and scrotal pathology. Acute scrotal pain requires an urgent surgical opinion and ultrasound of the scrotum should only be performed after discussion of the circumstances with a surgeon.

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